Among patients with triple-class exposed (TCE) relapsed or refractory multiple myeloma (RRMM), those treated with the BCMA x CD3 bispecific antibody teclistamab in the single-arm MajesTEC-1 trial had significantly improved outcomes compared with a retrospective control arm consisting of patients who met the MajesTEC-1 key inclusion criteria and received physician’s choice (PC) of subsequent therapy following the discontinuation of study treatment in one of four clinical trials of daratumumab.

After a median follow-up of 14 months for the Majes-TEC cohort and an estimated median follow-up of 30.9 months for the PC cohort, median overall and progression-free survival were 18.3 and 11.3 months, respectively, for patients receiving teclistamab, compared with 9.4 and 5.7 months, respectively, for those receiving PC. The study, based on an analysis of individual patient-level data, appears in the May issue of Clinical Lymphoma, Myeloma and Leukemia.

The analysis involved 165 patients enrolled in MajesTEC-1 and cohorts of 264 and 187 control patients, respectively, for the primary analysis, which controlled for nine prognostic factors, and the fully adjusted comparison, which controlled for 14 prognostic factors. Control patients had participated in the POLLUX, CASTOR, EQUULEUS, and APOLLO trials. The PC cohort featured the use of 248 unique regimens.

“In the absence of head-to-head trials comparing teclistamab with other treatments, this adjusted treatment comparison demonstrates that teclistamab offers substantial clinical benefit over physician’s choice of therapy for patients with TCE RRMM who received [at least] 3 prior [lines of therapy],” the authors, led by María-Victoria Mateos, MD, PhD, of University Hospital of Salamanca, Spain, wrote.

• Mateos MV, Chari A, Usmani SZ, et al. Comparative Efficacy of Teclistamab Versus Physician's Choice of Therapy in the Long-term Follow-up of APOLLO, POLLUX, CASTOR, and EQUULEUS Clinical Trials in Patients With Triple-class Exposed Relapsed or Refractory Multiple Myeloma. Clin Lymphoma Myeloma Leuk. 2023;23(5):385-393. doi:10.1016/j.clml.2023.02.006

Tags: study, bispecific t cell engagers, BCMA, multiple myeloma, Therapy, Refractory, BiTEs, Transplant, bispecific